title: Usefulness of pharmacist-assisted screening and psychiatric referral program for outpatients with cancer undergoing chemotherapy.
abstract: OBJECTIVE
  Major depressive disorder (MDD) and adjustment disorder (AD) are common psychiatric disorders in cancer patients but are often overlooked in clinical oncology settings. We introduced a clinical screening program utilizing the Distress and Impact Thermometer (DIT) to identify MDD and AD in cancer outpatients receiving chemotherapy. This study assessed the usefulness of the screening program.
  
  
  METHODS
  Pharmacists administered the DIT to consecutive patients undergoing chemotherapy at an outpatient clinic. Psychiatric treatment was recommended to all the patients with positive screening results. The proportion of patients referred to the Psychiatric Service during the program period was then compared with that during a usual care period.
  
  
  RESULTS
  Of the 520 patients who started chemotherapy during the 6-month program period, 5.0% (26/520) were referred to the Psychiatric Service and 2.7% (15/520) were diagnosed as having MDD or AD. No statistically significant difference in the referral rates was observed between the two periods (2.7 vs 1.0%, p = 0.46). However, the period from the first chemotherapy treatment until the visit to the Psychiatric Service was significantly shorter during the program period than during the period of usual care (12.9±13.2 days vs 55.6±17.6 days, p<0.001).
  
  
  CONCLUSIONS
  The proportion of patients referred to the Psychiatric Service for the treatment of MDD or AD during the program period was not different from that during the usual care period. However, the program was useful for introducing psychiatric treatment at an earlier stage. Further modifications to the program to improve the referral rate are necessary.
authors.affiliation: Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Ito
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ichida
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Asao
authors.initials: A
authors.lastname: Ogawa
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.forename: Naoko
authors.initials: N
authors.lastname: Kaneko
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Ueda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakayama
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000368:Aged; D000553:Ambulatory Care; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D010147:Pain Measurement; D010348:Patient Care Team; D010595:Pharmacists; D012017:Referral and Consultation / Q000706:statistics & numerical data